3D printing enables patients to pick up a model of their spine and allows the physician to outline their condition and show how the surgical procedure will correct the anomaly.

3D printing services for medical modeling are available at low cost and with a fast turnaround at Mount Sinai Health System’s new Medical Modeling Core. The onsite 3D printing has many clinical applications, ranging from pre-surgical planning to patient consultation.

Researchers at Mount Sinai have developed segmentation tools and software tools to expedite the process of turning radiological data into models appropriate for 3D printing and modeling. These services have been available for direct clinical applications at the institution for approximately 1 year and have aided approximately 50 cases. Recent prints include spine modeling for the correction of severe scoliosis, skull-base tumors with surrounding vasculature and cranial nerves, and pelvic models for the planning of arthroplasty.

“Our simulation, prototyping, and 3D printing resources developed here at Mount Sinai are rare for a medical institution,” said Joshua Bederson, MD, Professor and System Chair for the Department of Neurosurgery at Mount Sinai Health System and Clinical Director of the Neurosurgery Simulation Core. “These models are used in the planning stages for minimally invasive approaches and can be a trial run for the surgery. In conjunction with simulation, they also play an important role in the patient consultation process,” Dr. Bederson said in a statement to the press.

3D Printing of the Spine’s Bony Anatomy Can Be Done Inexpensively and Easily
Modeling the bony anatomy of the spine based on a standard CT scan is relatively easy, said Anthony Costa, PhD, who is leading the team handling 3D printing services. Segmenting is typically easier than modeling soft tissues, explained Dr. Costa, who is Assistant Professor of Neurosurgery and Scientific Director of the Neurosurgery Simulation Core at the Icahn School of Medicine at Mount Sinai.

In fact, 3D printing was recently used for both preoperative planning and postoperatively in a pediatric case of severe scoliosis (≥90° curvature), Dr. Costa explained.

“In the preoperative planning stage, we made a bony model of the entire spine from C1 to the sacrum, and cropped that for the important segments where the surgeon was going to be operating,” Dr. Costa said (Figure 1). “That model was used ahead of time to plan the relationship between all of the bony anatomy and the hardware to be placed.”Figure 1. Preoperative 3D printed model of child’s spine demonstrating severe scoliosis. Printed on 3D Systems’ ProJet 660Pro 3D Printer. Reprinted with permission from Anthony Costa, PhD.Next, the model was placed in a sterilized bag so that it could be mounted in the operating room. The model was interrogated for its relationship to the patient’s position on the operating table, enabling the surgeons to better orient themselves during the procedure, Dr. Costa explained.

Use of 3D printing in this case actually led to a change in the way the surgery was performed. “It was one of those sort of aha moments where we realized the potential power of 3D modeling used intra-operatively,” Dr. Costa said. A virtual reconstruction and interactive model of spine and implanted hardware is shown in Figure 2.Figure 2. Virtual reconstruction and interactive model of spine and implanted hardware after procedure to correct severe scoliosis in a child. Reprinted with permission from Anthony Costa, PhD.3D Printing Aids Patient Counseling
“When patients come in and are told that they require a surgical procedure, it is often difficult for them to have a clear picture of what is going on in their own body,” Dr. Costa explained. 3D printing enables patients to pick up a model of their spine or other piece of anatomy, and allows the physician to outline their condition and show how the surgical procedure will correct the anomaly, Dr. Costa said.

“This offers patients confidence about what is about to happen to them. We have found this to be a very successful approach,” Dr. Costa told SpineUniverse.

“We’re unique because we can leverage our technological tools with the expertise of radiology and the printing lab to complete projects on a rapid time scale,” Dr. Costa said. “We’re talking about days as opposed to weeks. Mount Sinai is a large institution with a high volume of cases, and our patients will benefit from 3D modeling.”